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1.
Rev. bras. ginecol. obstet ; 42(7): 397-403, July 2020. tab, graf
Article in English | LILACS | ID: biblio-1137849

ABSTRACT

Abstract Objective To evaluate the diagnostic accuracy of cancer antigen 125 (CA125) and complete blood count (CBC) parameters, such as the neutrophil to lymphocyte ratio (NLR), the platelet to lymphocyte ratio (PLR), and thrombocytosis in patients with ovarian masses. Methods The present is a retrospective study conducted at a single tertiary hospital from January 2010 to November 2016. We included consecutive women referred due to suspicious adnexal masses. The CBC and CA125 were measured in the serum of 528 women with ovarian masses before surgery or biopsy. We evaluated the diagnostic performance of the NLR, PLR, platelets (PLTs), CA125, and the associations between them. We tested the clinical utility of the CBC parameters and CA125 in the discrimination of ovarian masses through decision curve analysis (DCA). Results The best balance between sensitivity and specificity was obtained by the associations of CA125 or PLTs ≥ 350/nL, with 70.14% and 71.66%, CA125 or PLTs ≥ 400/ nL, with 67.30% and 81.79%, CA125 or PLR, with 76.3% and 64.87%, and CA125 or NLR, with 71.09% and 73.89% respectively. In the DCA, no isolated CBC parameter presented a higher clinical utility than CA125 alone. Conclusion We showed that no CBC parameter was superior to CA125 in the prediction of the malignancy of ovarian tumors in the preoperative scenario.


Resumo Objetivo Avaliar a acurácia diagnóstica do antígeno de câncer 125 (cancer antigen 125, CA125, em inglês) e dos parâmetros do hemograma como as razões neutrófilo/linfócito (RNL), plaqueta/linfócito (RPL), e trombocitose em pacientes com massas ovarianas. Métodos Este é um estudo retrospectivo realizado em um hospital terciário no período de janeiro de 2010 a novembro de 2016. Foram incluídas de forma consecutiva mulheres encaminhadas por massas anexiais suspeitas. Foram dosados hemogramas e CA125 no soro de 528 mulheres com massas ovarianas antes da cirurgia ou biópsia. Foram avaliados os desempenhos diagnósticos da RNL, da RPL, das plaquetas (PLQs) e do CA125, considerando-os isoladamente e associados entre si. Testamos a utilidade clínica dos parâmetros do hemograma e do CA125 na discriminação das massas ovarianas por análise de curva de decisão (ACD). Resultados Os melhores equilíbrios entre sensibilidade e especificidade foram obtidos por meio das associações do CA125 ou PLQs ≥ 350/nL, com 70,14% e 71,66%, CA125 ou PLQs ≥ 400/nL, com 67,30% e 81,79%, CA125 ou RPL, com76,3% e 64,87%, e CA125 ou RNL, com 71,09% e 73,89%, respectivamente. Conclusão Na ACD, nenhum parâmetro do hemograma isolado se mostrou superior ao CA125 na predição de malignidade de tumores ovarianos no pré-operatório.


Subject(s)
Humans , Female , Ovarian Neoplasms/diagnosis , Ovarian Neoplasms/pathology , Platelet Count , Thrombocytosis/pathology , Lymphocytes/cytology , Lymphocyte Count , Neutrophils/cytology , Retrospective Studies , CA-125 Antigen/blood , Preoperative Period
2.
Rev. cuba. hematol. inmunol. hemoter ; 36(2): e992, abr.-jun. 2020.
Article in Spanish | LILACS, CUMED | ID: biblio-1149895

ABSTRACT

Introducción: Las alteraciones cuantitativas de plaquetas son producidas por el incremento o disminución de los conteos globales de plaquetas. El incremento o trombocitosis se produce por redistribución o aumento de la producción medular; la disminución puede ser el resultado de una reducción de la producción, redistribución o acortamiento de la sobrevida de las plaquetas en circulación. Objetivo: Describir los hallazgos citomorfológicos más importantes en las alteraciones cuantitativas de plaquetas. Métodos: Se realizó una revisión de la literatura, en inglés y español, en la base de datos PubMed y el motor de búsqueda Google Académico de artículos publicados en los últimos 10 años. Se hizo un análisis y resumen de la bibliografía revisada. Análisis y síntesis de la información: Las alteraciones cuantitativas de plaquetas se caracterizan por variaciones en el número y morfología de estas células. Estas se asocian a causas congénitas o adquiridas, en la que la detallada anamnesis de los pacientes es un elemento importante en el diagnóstico. En la trombocitosis se debe diferenciar una trombocitosis reactiva de una enfermedad medular primaria; mientras que en la trombocitopenia se debe considerar el origen étnico de los pacientes y la morfología de los leucocitos. Son numerosas las causas hereditarias de trombocitopenia con anomalías morfológicas de plaquetas y granulocitos. Conclusiones: Las alteraciones cuantitativas de plaquetas son un amplio número de entidades con semejanzas y diferencias en cuanto a presentación y manifestaciones clínicas. Los exámenes de laboratorio constituyen una herramienta importante en el diagnóstico, pronóstico y el seguimiento de los pacientes afectados(AU)


Introduction: Quantitative platelet alterations are produced by the increase or decrease in global platelet counts. Platelet count increase or thrombocytosis is produced by redistribution or increased marrow production. Platelet decrease may result from production, redistribution, or shortened survival of circulating platelets. Objective: To describe the most significant cytomorphological findings in quantitative platelet alterations. Methods: A literature review was carried out, in English and in Spanish, in the database PubMed and with the search engine of Google Scholar, of articles published in the last ten years. An analysis and summary of the revised bibliography was made. Information analysis and synthesis: Quantitative platelet alterations are characterized by variations in the number and morphology of these cells. These are associated with congenital or acquired causes, in which detailed anamnesis of patients is an important element in the diagnosis. In thrombocytosis, reactive thrombocytosis must be differentiated from primary marrow disease; while in thrombocytopenia, the ethnic origin of the patients and the morphology of the leukocytes must be considered. Hereditary causes of thrombocytopenia with morphological abnormalities of platelets and granulocytes are numerous. Conclusions: Quantitative platelet alterations are a large number of entities with similarities and differences in terms of presentation and clinical manifestations. Laboratory tests are an important tool for diagnosis, prognosis, and follow-up of affected patients(AU)


Subject(s)
Humans , Platelet Count/methods , Thrombocytopenia/diagnosis , Thrombocytosis/diagnosis , Cells/cytology , Blood Platelets/pathology
3.
Hematol., Transfus. Cell Ther. (Impr.) ; 42(1): 46-53, Jan.-Mar. 2020. tab, graf
Article in English | LILACS | ID: biblio-1090480

ABSTRACT

Abstract Introduction Ruxolitinib has been approved for the treatment of myelofibrosis (MF). In this study, we present safety and efficacy findings from an analysis of 104 patients with intermediate- and high-risk MF in a Brazilian cohort of the JUMP study who received treatment with ruxolitinib. Methods JUMP is a single-arm, open-label, phase IIIb, expanded-access study. The primary endpoint was to evaluate the safety and tolerability (frequency, duration, and severity of adverse events [AEs]) of ruxolitinib. Results All of the 104 patients received the treatment. Median duration of exposure was 35.8 months. The most common hematologic AEs were anemia (57.7), thrombocytopenia (38.5%), neutropenia (11.5%), and leukopenia (9.6%). Second malignancies (all grades) occurred in 19.2% of patients (n = 20). Serious AEs were reported in 62.5% of patients (n = 65). The proportions of patients with ≥50% reduction from baseline in palpable spleen length at weeks 24 and 48 were 62.7% and 69.2%, respectively. The mean change from the baseline in the Functional Assessment of Cancer Therapy (FACT)-Lymphoma total score was 10.8 [15.6%] at week 4, 12.6 [14.1%] at week 24, and 12.2 [14.3%] at week 48. The mean change from the baseline for the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue scale was 3.9 [42.8%] at week 4, 4.9 [29.9%] at week 24, and 4.7 [28%] at week 48. At week 48, the estimated progression-free survival, leukemia-free survival, and overall survival probabilities were 91%, 91% and 93%, respectively Overall, 21 deaths were observed in the present study. Conclusion Findings from this study suggest that ruxolitinib could be evaluated as a standard-of-care treatment for the MF population in need of a viable treatment option. NCT01493414


Subject(s)
Humans , Male , Adult , Middle Aged , Aged , Aged, 80 and over , Drug Therapy , Primary Myelofibrosis/therapy , Polycythemia , Splenomegaly , Thrombocytosis , Brazil
4.
Rev. bras. anal. clin ; 52(1): 27-31, 20200330.
Article in Portuguese | LILACS | ID: biblio-1104127

ABSTRACT

Trombose essencial é uma das doenças mieloproliferativas crônicas, rara e de etiologia ainda desconhecida, mas que apresenta risco alto de eventos trombóticos e/ou hemorrágicos, uma vez que acomete as células megacariocíticas e, consequentemente, as plaquetas. O objetivo deste trabalho foi realizar uma revisão das publicações sobre o tema abordado. O estudo caracteriza-se como revisão bibliográfica de artigos das bases de dados da Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), National Library of Medicine (PubMed), Scientific Electronic Library Online (SciELO) e Google acadêmico. Foram incluídos artigos disponíveis e em qualquer idioma de publicação, com a finalidade de aumentar o referencial teórico. Posteriormente à seleção e análise dos artigos, foram encontrados alguns pontos em comum, como a dificuldade em se diagnosticar a doença. De acordo com os estudos, a maioria dos doentes é assintomática, mas pode apresentar desde eventos trombóticos até mesmo embolia pulmonar. Atualmente, o tema vem crescendo, principalmente abordando técnicas moleculares mais específicas para a descoberta da doença em seu estágio inicial. A análise dos artigos demonstrou a dificuldade do diagnóstico da trombose essencial, sendo a sua identificação crucial nos estágios iniciais.


Essential thrombosis is one of the chronic myeloproliferative diseases, rare and of unknown etiology, but which presents a high risk of thrombotic and / or hemorrhagic events. Once it attacks the megakaryocytic cells and consequently the platelets. The objective of this work is to review the publications on the subject. The study is characterized as a bibliographical review of articles from the Latin American and Caribbean Literature in Health Sciences (LILACS), National Library of Medicine (PubMed), Scientific Electronic Library Online (SciELO) and Google Acadêmico. Articles were included and in any language of publication, in order to increase the theoretical reference. Subsequent to the selection and analysis of the articles, some common points were found such as the difficulty in diagnosing the disease. According to the studies, the majority of patients are asymptomatic but may present from thrombotic events to even pulmonary embolism. Currently, the topic has been growing, mainly addressing molecular techniques more specific to the discovery of the disease in its initial stage. The analysis of the articles demonstrated the difficulty of diagnosing essential thrombosis, which is crucial in the initial stages.


Subject(s)
Thrombocytosis , Janus Kinase 2 , Thrombocythemia, Essential
6.
São Paulo; HSPM; 2019.
Non-conventional in Portuguese | LILACS, ColecionaSUS, SMS-SP, HSPM-Producao, SMS-SP | ID: biblio-1247948

ABSTRACT

RESUMO A doença celíaca (DC) é uma forma crônica de enteropatia de mecanismo imunológico que afeta o intestino delgado de crianças e adultos geneticamente predispostos, precipitada pela ingestão de alimentos contendo glúten. Também é conhecida como espru celíaco, enteropatia sensível ao glúten ou espru não tropical. A doença pode se manifestar na forma Clássica, Não Classica e assintomática. Para o diagnostico é imprescindível a realização de endoscopia digestiva alta com biópsia de intestino delgado, considerado o padrão-ouro. Os marcadores sorológicos são úteis para identificar os indivíduos que deverão ser submetidos à biópsia de intestino delgado e também são úteis para acompanhamento do paciente celíaco. Os principais testes sorológicos para a detecção da intolerância ao glúten são o anticorpo antigliadina, o anticorpo antiendomísio e o anticorpo antitransglutaminase (TTG). O tratamento da DC consiste na introdução de dieta isenta de glúten de forma permanente, devendo-se, portanto, excluir da dieta os seguintes cereais e seus derivados: trigo, centeio, cevada, malte, aveia. Neste trabalho relatamos o caso de um paciente com diagnóstico tardio de DC, que iniciou o quadro com enteropatia perdedora de proteína, com quadro infeccioso vigente, PCR aumentado, leucocitose, plaquetose e hipoalbuminemia. Realizada EDA com biópsia que juntamente com anti endomisio IgA positivo resultaram no diagnóstico de DC. Paciente manteve-se com leucocitose e plaquetose. O objetivo deste relato é apresentar uma paciente com diagnóstico de DC e revisar aspectos clínicos e terapêuticos atuais da doença. Palavras-chave: Doença Celíaca; Enteropatia Perdedora de Proteína ; Plaquetose; Leucocitose.


Subject(s)
Humans , Male , Female , Protein-Losing Enteropathies , Thrombocytosis , Celiac Disease , Leukocytosis
7.
Journal of Experimental Hematology ; (6): 1607-1611, 2019.
Article in Chinese | WPRIM | ID: wpr-775677

ABSTRACT

OBJECTIVE@#To explore the effect of high volume platelet reduction therapy on the white blood cell (WBC) count and hemoglobin (Hb) level in patients with thrombocytosis.@*METHODS@#Thirty-two plateletphoreses were performed for patients with thromocytosis by using ELP or MNC program of blood component isolator of COBE spectra continuous flow concentrifugation and the ACD-A preservation solution for blood as blood anticoagulant. In each treatment of patients, 2.5-3.0 tines total blood volume (TBV) were circulated, then the platelet suspension of 1/5-1/4 time TBV was prepared and collected.@*RESULTS@#A single plateletpheresis took (212.53±41.54) minutes in which (8 812.63±2087.15) ml blood were treated, and (798.84±190.77) ml platelet suspension was collected. In the suspension, the platelet count was 4 486.50 (3 058.50-5 279.50)×10/L, containing 3 455.50 (2 288.68-4 226.71)×10. WBC count was 13.79 (10.21-20.72)×10/L, containing 11.90(7.81-14.40)×10. Hemoglobin concentration was (3.28±1.25) g/L,containing (2.62 ± 1.17) g. Before and after plateletpheresis, the patients' platelet count was 1 263.00 (1 052.50-1 807.50)×10/L and (778.83±247.25)×10/L(Z=4.94, P<0.01), WBC count was 9.96(6.44-14.01)×10/L and 8.59(5.37, 13.12)×10/L (Z=13.31, P<0.05), Hemoglobin concentration was (112.63 ± 24.56)g/L and (109.55 ± 24.46)g/L (t=1.68,P>0.05).@*CONCLUSION@#Using continuous flow centrifugation and blood component separating in plateletpheresis for the patients with thrombocytosis can obviously decrease the high ratio of platelets, and improve the effect of plateletpheresis. The high volume platelet reduction therapy can lead to decrease of WBC count to some alent, degree but WBC count still in the normal range, moreover not affect the hemoglobin level significantly.


Subject(s)
Hemoglobins , Humans , Leukocyte Count , Platelet Count , Plateletpheresis , Thrombocytosis
8.
Article in English | WPRIM | ID: wpr-719245

ABSTRACT

OBJECTIVE: To investigate the association between pre-treatment thrombocytosis and prognosis in patients with ovarian cancer (OC). METHODS: PubMed, EMBASE, and the Cochrane Library were searched for articles regarding the prognosis of OC patients with pre-treatment thrombocytosis by the end of March 2018. Pooled estimates for overall survival (OS) and progression-free survival (PFS) events were calculated as hazard ratios (HRs) either on a fixed or random effect model by Stata 13.0 software. Funnel plot and Egger's test were applied to evaluate publication bias and sensitivity analyses were undertaken to estimate the strength of outcomes. RESULTS: Eleven studies that met the inclusion criteria were enrolled, including a total of 4,953 patients. Pooled results showed that pre-treatment thrombocytosis was significantly associated with OS (HR=1.722; 95% confidence interval [CI]=1.437–2.064) and PFS (HR=1.452; 95% CI=1.323–1.593) in the cohort. Significant correlation was found in OS and PFS between pre-treatment thrombocytosis and both epithelial OC (all stages and differentiation degrees of OC) and advanced epithelial OC (III or IV) by subgroup analyses, which were performed according to publication year, country, case numbers, OC category, International Federation of Gynecology and Obstetrics stage, and cut-off value. However, subgroup analyses indicated no significant correlation between pre-treatment thrombocytosis and OS for patients with high-grade serous (poorly differentiated or undifferentiated) OC (HR=1.220; 95% CI=0.946–1.573; p=0.125). Egger's test demonstrated no obvious publication bias in the articles enrolled in this study (OS: p=0.226; PFS: p=0.071). CONCLUSION: Pre-treatment thrombocytosis might be taken as an independent prognostic indicator for patients with OC.


Subject(s)
Cohort Studies , Disease-Free Survival , Gynecology , Humans , Obstetrics , Ovarian Neoplasms , Prognosis , Publication Bias , Publications , Thrombocytosis
9.
Korean Circulation Journal ; : 755-765, 2019.
Article in English | WPRIM | ID: wpr-759456

ABSTRACT

BACKGROUND AND OBJECTIVES: Immunological variability in Kawasaki disease (KD) shows age-specific differences; however, specific differences in laboratory values have not been compared between infants and non-infants with KD. We compared age-adjusted Z-values (Z) of white and red blood cells in infants with KD with those in non-infants with KD. METHODS: This study retrospectively investigated 192 infants and 667 non-infants recruited between 2003 and 2015 at the Korea University Hospital. Laboratory values for infants with KD and non-infants with KD were analyzed and age-unadjusted raw values (R) and age-adjusted Z for blood cells counts were determined. RESULTS: Z in infants with KD during pre-intravenous immunoglobulin (IVIG), post-IVIG, and chronic phases showed increased lymphopenia and eosinophilia, low neutrophil:lymphocyte and neutrophil:eosinophil ratios, worse anemia, increased thrombocytosis, and reduced erythrocyte sedimentation rates compared with those in non-infants with KD. The optimal cut-off value for pre-IVIG Z-hemoglobin for prediction of KD in all patients was 40 mg/L (AUC, 0.811; sensitivity/specificity, 0.712/0.700; p=0.04). CONCLUSIONS: Laboratory characteristics enable differentiation between infants and non-infants with KD and contribute to a better understanding of changes in blood cell counts. Infants with incomplete KD can be more easily differentiated from infants with simple febrile illness using pre-IVIG Z-hemoglobin and pre-IVIG CRP values.


Subject(s)
Anemia , Blood Cell Count , Blood Cells , Blood Sedimentation , C-Reactive Protein , Eosinophilia , Erythrocytes , Humans , Immunoglobulins , Infant , Korea , Leukocyte Count , Lymphopenia , Mucocutaneous Lymph Node Syndrome , Retrospective Studies , Thrombocytosis
10.
Article in Korean | WPRIM | ID: wpr-761395

ABSTRACT

OBJECTIVE: Myeloproliferative neoplasm (MPN) is considered as one of the risk factors of ischemic stroke. Some MPN patients manifest stroke as their first symptom. Our purpose was to assess diagnostic rate of MPN in newly diagnosed acute ischemic stroke patients. METHODS: This study was performed using National Health Insurance Service Ilsan Hospital dataset. Data retrieving was performed by defining by defining the patient with coding of acute ischemic stroke from January 2013 to June 2017. We selected only the patients who had checked brain magnetic resonance imaging and complete blood cell count (CBC) in emergency room or on admission. Among the results of CBC finding, hemoglobin and platelet count were analyzed. Erythrocytosis was defined >16.5 g/dL (male), >16 g/dL (female) according to revised World Health Organization (WHO) classification of polycythemia vera (PV) criteria. Thrombocytosis was >450,000/µL according to revised WHO classification of essential thrombocythemia (ET). RESULTS: Total number of newly diagnosed acute ischemic stroke was 1,613 patients. Seven patients (0.43%) were diagnosed MPN (ET=2, PV=5) after ischemic stroke. Patients who had thrombocytosis and erythrocytosis were 18 and 105, respectively. Three patients who had thrombocytosis were diagnosed MPN (ET=2, PV=1). Two patients with erythrocytosis were diagnosed MPN (PV=2). Two patients had both thrombocytosis and erythrocytosis, and two of them were diagnosed PV. Seventy-one patients who had erythrocytosis were normalized in follow-up period. Six patients who had thrombocytosis and 30 patients who had erythrocytosis did not further evaluate. CONCLUSION: CBC has to be carefully read and MPN can be suspected. Diagnosis must be confirmed by hematologist to initiate appropriate treatment. It is important to recognized suspected MPN patients to prevent stroke.


Subject(s)
Blood Cell Count , Brain , Classification , Clinical Coding , Dataset , Diagnosis , Emergency Service, Hospital , Follow-Up Studies , Humans , Magnetic Resonance Imaging , National Health Programs , Platelet Count , Polycythemia , Polycythemia Vera , Risk Factors , Stroke , Thrombocythemia, Essential , Thrombocytosis , World Health Organization
12.
Article in Korean | WPRIM | ID: wpr-766679

ABSTRACT

A 30-year-old woman in her first pregnancy was admitted with headache and horizontal diplopia indicating left abducens nerve palsy. Brain magnetic resonance imaging revealed a cerebral venous thrombosis. She had thrombocytosis in the peripheral blood, and a genetic test for thrombocytosis revealed the presence of the valine-to-phenylalanine (V617F) mutation of the Janus kinase 2 (JAK2) gene. Treatment with low-molecular-weight heparin resolved her symptoms of headache and diplopia. The presence of genetic disorders such as the JAK2-V617F gene mutation should be assessed in patients with cerebral venous thrombosis and coexisting thrombocytosis.


Subject(s)
Abducens Nerve Diseases , Adult , Brain , Diplopia , Female , Headache , Heparin, Low-Molecular-Weight , Humans , Janus Kinase 2 , Magnetic Resonance Imaging , Pregnancy , Thrombocytosis , Venous Thrombosis
13.
Article in English | WPRIM | ID: wpr-715738

ABSTRACT

BACKGROUND: Non-conversion of sputum smear and culture prolongs the infectivity of the patient and has been associated with unfavorable outcomes. We aimed to evaluate factors associated with persistent sputum positivity at the end of two months of treatment of new case pulmonary tuberculosis (TB). METHODS: Data of 87 human immunodeficiency virus-negative patients with culture-positive drug-susceptible pulmonary TB admitted to local university hospital between September 2015 and September 2016 were reviewed. Factors associated with sputum smear and/or culture positivity at the end of the second month of treatment were analyzed. RESULTS: Twenty-two patients (25.3%) remained smear and/or culture-positive. Male sex, lower body mass index (BMI), unemployment, alcohol abuse, higher number of lobes involved and cavities on chest X-rays, shorter time to detection (TTD) on liquid cultures, higher respiratory sample smear grading and colony count in solid cultures, higher C-reactive protein, erythrocyte sedimentation rate, leukocytosis, thrombocytosis, and anemia were all significantly associated with persistent sputum positivity. However, in the logistic regression analysis only male sex, lower BMI, alcohol abuse, higher radiological involvement, cavitation, higher smear grading, higher colony count in solid cultures and shorter TTD were determined as independent factors associated with persistent sputum positivity at the end of 2 months of treatment. CONCLUSION: In conclusion, higher sputum smear and culture grading at diagnosis, shorter TTD, higher number of lobes involved, cavitation, male sex, alcohol abuse, and lower BMI were independently associated with persistent sputum positivity. These factors should be sought when distinguishing which patients will remain infectious longer and possibly have worse outcomes.


Subject(s)
Alcoholism , Anemia , Blood Sedimentation , Body Mass Index , C-Reactive Protein , Diagnosis , Humans , Leukocytosis , Lithuania , Logistic Models , Male , Risk Factors , Sputum , Thorax , Thrombocytosis , Treatment Outcome , Tuberculosis , Tuberculosis, Pulmonary , Unemployment
14.
Blood Research ; : 233-239, 2018.
Article in English | WPRIM | ID: wpr-716607

ABSTRACT

BACKGROUND: Reactive thrombocytosis (RT) is a common condition among children, although no studies have examined the etiology or clinical characteristics of RT among Korean children. METHODS: This retrospective study evaluated children with RT at a single Korean tertiary center during a 10-year period. RESULTS: RT accounted for 13.5% of children who were admitted to the pediatric ward (4,113/30,355): mild RT, 82.7%; moderate RT, 14.1%; severe RT, 1.1%; and extreme RT, 2.1%. There was a negative correlation between platelet count and Hb level (P=0.008). There were positive correlations between platelet count and WBC (P=0.001), erythrocyte sedimentation rate (ESR) (P=0.007), and admission duration (P=0.006). The most common cause of RT was infection and the second most common was Kawasaki disease (KD). The highest proportion of lower respiratory tract infection was observed in extreme RT (P < 0.001). The proportion of KD was highest in extreme RT (P < 0.001) and in children aged 1–7.9 years (P < 0.001). The proportion of refractory KD was highest in extreme RT (P=0.005). In cases of KD, there was a positive correlation between platelet count and fever duration (P=0.006). Non-KD autoimmune inflammation was only observed in mild/moderate RT, and its proportion was highest in children aged 8–18 years (P < 0.001). CONCLUSION: In children, more severe RT was associated with lower Hb, increased WBC, ESR, and prolonged admission. With respiratory infection or KD, extreme RT was associated with more severe disease course.


Subject(s)
Blood Sedimentation , Child , Fever , Humans , Inflammation , Mucocutaneous Lymph Node Syndrome , Platelet Count , Respiratory Tract Infections , Retrospective Studies , Thrombocytosis
15.
Article in English | WPRIM | ID: wpr-728830

ABSTRACT

Drug reaction with eosinophilia and systemic symptoms(DRESS), which occurs 2–8 weeks after taking a medication is a rare and potentially life-threatening drug-induced hypersensitivity reaction, which includes skin eruption, hematologic abnormalities, lymphadenopathy, and internal organ such as liver, lung, kidney involvement. Antiepileptic agents (e.g., carbamazepine, lamotrigine, phenytoin, and phenobarbital) and allopurinol are the most commonly reported causes. However, new antiepileptic agents, such as oxcarbazepine, rarely cause drug reaction with eosinophilia and systemic symptoms. A 11-year-old boy who was administered oxcarbazepine for 34 days developed widespread rashes, facial edema, fever, cough, nasal stuffiness, tonsillitis, and cervical lymphadenopathy. Laboratory test results showed leukocytosis, eosinophilia, thrombocytosis, elevated c-reactive protein, and elevated liver transaminase levels. As we suspected drug reaction with eosinophilia and systemic symptoms, we immediately withdrew oxcarbazepine and commenced corticosteroid therapy. The patient's skin lesions and abnormal laboratory results slowly improved. Before change the antiepileptic agents, we performed human leukocyte antigen (HLA) typing to assess the genetic risk factors of the drug reaction and the result was positive for HLA DRB1*04:03 known to cause severe acute drug hypersensitivity, such as Stevens-Johnson syndrome by oxcarbazepine in Koreans. We have presented the first report of drug reaction with eosinophilia and systemic symptoms associated with oxcarbazepine in a patient with HLA DRB1*04:03. Although DRESS by oxcarazepine is extremely rare and unpredictable, when suspected clinical symptoms occur, it is necessary to interrupt the causative drug rapidly and confirming the patient's HLA typing may help to select a safer alternative drug.


Subject(s)
Allopurinol , Anticonvulsants , C-Reactive Protein , Carbamazepine , Child , Cough , Drug Eruptions , Drug Hypersensitivity , Drug Hypersensitivity Syndrome , Edema , Eosinophilia , Exanthema , Fever , Histocompatibility Testing , Humans , Hypersensitivity , Kidney , Leukocytes , Leukocytosis , Liver , Lung , Lymphatic Diseases , Male , Palatine Tonsil , Phenytoin , Risk Factors , Skin , Stevens-Johnson Syndrome , Thrombocytosis , Tonsillitis
16.
San Salvador; s.n; 2018. 54 p. graf.
Thesis in Spanish | LILACS, BISSAL | ID: biblio-1177645

ABSTRACT

Los neonatos son susceptibles a diversas enfermedades en los que juega un rol importante la detección temprana. Con el uso del conteo electrónico de plaquetas como parte del hemograma de rutina, la trombocitosis y trombocitopenia se observan con mayor frecuencia como un hallazgo inesperado, y en nuestro medio no se encuentran descripciones respecto al tema, por lo que se realizará el siguiente estudio. Se realizó un estudio descriptivo, transversal, retrospectivo. De una población de 589 ingresados, se seleccionaron los casos con conteos plaquetarios mayores de 450,000 plaquetas o menores de 150,000 plaquetas. Se excluyeron 18 pacientes que presentaban criterios de exclusión, y 6 pacientes cuyos expedientes no fueron encontrados. Quedando 76 sujetos sometidos al estudio. La edad media de la población que presentó alteración cuantitativa de plaquetas fue de 8 días. Con sexo masculino de 61%. La prevalencia trombocitosis fue del 5% y la de trombocitopenia del 7%. Para todos los grupos de edad gestacional se obtuvo una mayor frecuencia de trombocitopenia. La mayor parte de los casos encontrados corresponden a alteraciones leves. Se observó trombocitopenia con una frecuencia tres veces mayor que la de trombocitosis en los neonatos en las categorías de bajo peso. En la población con sepsis y sospecha de sepsis se encontró una mayor frecuencia de trombocitosis. Únicamente 8% de la población neonatal con trombocitosis o trombocitopenia presentaba anemia


Subject(s)
Thrombocytopenia , Thrombocytosis , Pediatrics
17.
Rev. ecuat. pediatr ; 18(2): 14-16, diciembre 2017.
Article in Spanish | LILACS | ID: biblio-996587

ABSTRACT

El Síndrome de Ivemark se clasifica como un trastorno de Heterotaxia o un trastorno de lateralidad de baja incidencia, que debuta con manifestaciones clínicas caracterizados por latidos cardiacos a la derecha y asplenia entre otras malformaciones, se puede asociar a un patrón de herencia autosómico recesivo que es el más frecuente. Se destaca que entre las malformaciones más frecuentes del aparato digestivo se encuentra la mal rotación intestinal la cual fue descartada y los signos de distensión abdominal y mala tolerancia alimentaria se debió a la descompensación gradual del paciente. El diagnóstico prenatal mediante la ecocardiografía es pieza clave en el manejo posterior del paciente, debido que permite programar su nacimiento en centros de III nivel, por su alta complejidad y requerimiento de cirugía cardiotorácica, el manejo terapéutico de asplenia determina el pronóstico del paciente.


The Ivemark Syndrome is classified as a Heterotaxia disorder or a low incidence laterality disorder, which debuts with the clinical characteristics for right heartbeats and asplenia among other malformations, it can be associated with an autosomal recessive inheritance pattern that is the most frequent It is emphasized that the most frequent, malformations of the digestive system are in the phase of abdominal rotation that the discarded and the signs of abdominal distension and food intolerance were due to the gradual decompensation of the patient. Prenatal diagnosis through echocardiography is the key to the management of the birth of the patient, which allows to schedule its birth in the centers of III level, for its high complexity and requirement of cardiothoracic surgery, the therapeutic management of Asplenia determines the prognosis of the patient.


Subject(s)
Humans , Male , Infant, Newborn , Congenital Abnormalities , Heterotaxy Syndrome , Isomerism , Thrombocytosis , Heredity
18.
Blood Research ; : 8-8, 2017.
Article in English | WPRIM | ID: wpr-97880

ABSTRACT

No abstract available.


Subject(s)
Anemia, Refractory , Thrombocytosis
19.
Article in English | WPRIM | ID: wpr-161800

ABSTRACT

Essential thrombocytosis (ET) is a myeloproliferative disorder characterized by an anomalous increase in platelet production. Many patients with ET are asymptomatic. Few studies have reported ET-associated thromboembolism in large vessels such as the aorta. We report a patient with ET who presented with peripheral embolism from an abdominal aortic thrombus and developed acute limb ischemia. The patient underwent aortic replacement successfully. The patient’s platelet count was controlled with hydroxyurea, and no recurrence was noted over 2 years of follow-up.


Subject(s)
Aorta , Aorta, Abdominal , Blood Platelets , Embolism , Extremities , Follow-Up Studies , Humans , Hydroxyurea , Ischemia , Myeloproliferative Disorders , Platelet Count , Recurrence , Thrombocythemia, Essential , Thrombocytosis , Thromboembolism , Thrombosis
20.
Article in Korean | WPRIM | ID: wpr-179056

ABSTRACT

In essential thrombocythemia (ET), cerebral infarction with large cerebral artery occlusion has rarely been reported. A 53-year-old male was admitted with left sided weakness. Brain magnetic resonance images revealed right internal carotid artery (ICA) territory infarction and proximal ICA occlusion. The blood laboratory examination demonstrated continuously increased platelet count (above 617,000/µL). Increased megakaroycytes and JAK2 V617F mutation were confirmed in the bone marrow biopsy. We should consider the possibility of ET in patient with large artery thrombosis and thrombocythemia.


Subject(s)
Arteries , Biopsy , Bone Marrow , Brain , Carotid Artery, Internal , Cerebral Arteries , Cerebral Infarction , Humans , Infarction , Janus Kinase 2 , Male , Middle Aged , Platelet Count , Stroke , Thrombocythemia, Essential , Thrombocytosis , Thrombosis
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